Se the "NAICS Keyword Search" to enter one or more words that generally describe your business. For example, if you are in the restaurant business, enter "restaurant" and get a complete listing of NAICS codes for the restaurant industry. DWC005 Rev. 02/18 Page 2 of 3 Are any fields on the DWC Form-005 optional? DWC005 All applicable fields must be completed each time the DWC Form-005 is filed. Section I · Section II · The effective dates are always required. When reporting cancellation.
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How to fill out the TX DWC005 online
The Texas DWC005 form is essential for notifying the Texas Department of Insurance about your workers' compensation coverage status. This guide provides a step-by-step approach to assist you in accurately completing the form online.
Follow the steps to effectively complete the TX DWC005 online
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Fill in Section I regarding effective dates. Indicate the effective start and end dates of your coverage or termination. Remember that the effective dates cannot exceed a one-year period.
- Proceed to Section II and select the appropriate statement. Indicate whether your business does not have coverage or has terminated coverage, and provide the required details if applicable, including the policy termination date and the name of the insurance company.
- In Section III, answer the question about reportable injuries or diseases. Choose 'Yes' or 'No' based on whether you have had any incidents since your last notice.
- Complete Section IV by entering your employer business information, including name, Federal Employer ID number, mailing address, and business type. Ensure you provide the necessary details for any additional business locations.
- Finalize Section V by inputting the contact person's information, including their name, phone number, email address, and title. Please note that a signature is not required when filing online.
- After completing all sections, review your information for accuracy. You can then save changes, download, print, or share the completed form as necessary.
Complete your TX DWC005 form online today to ensure compliance with Texas workers' compensation requirements.
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